NPIMap

Individual provider Active NPI

Anselmo Pizzuti, MD

  • Pediatrics Physician
  • Canby, OR
National Provider Identifier
1699726877
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD07626 Issued in OR
Practice address
200 Hazel Dell Way
Suite 202
Canby, OR 97013
Phone
(503) 266-8500
Fax
(503) 266-8585
NPI assigned
May 13, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD07626 OR Primary

Addresses

Primary practice location

200 Hazel Dell Way
Suite 202
Canby, OR 97013

Mailing address

1510 Division St
Suite 280
Oregon City, OR 97045
Phone (503) 905-3400

Other identifiers 2

IdentifierTypeStateIssuer
160879MedicaidOR
370016731OtherRR PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD07626ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Medical Group, PC Past Accepting new patients
Willamette Falls Pediatric Group, PC Pediatrics Past Accepting new patients
Willamette Falls Pediatric Group Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61288

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1699726877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 DIVISION ST",
            "address_2": "SUITE 280",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "97045",
            "telephone_number": "503-905-3400",
            "fax_number": "503-905-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAZEL DELL WAY",
            "address_2": "SUITE 202",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "97013",
            "telephone_number": "503-266-8500",
            "fax_number": "503-266-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIZZUTI",
        "first_name": "ANSELMO",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD07626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160879",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PIN",
            "identifier": "370016731",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canby, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.